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Employee Sign Up
Employee Sign Up
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Employee Sign Up
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2023-04-24T22:47:03-04:00
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Employer Name:
*
Name
First
Middle
Last
Date Of Birth
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Gender
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Male
Female
Phone
*
Email
*
Street Address
City
State
Zip Code
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Spouse / Partner Full Name
Date of Birth
Gender
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Male
Female
Are you a Student?
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Yes
No
First Child/Dependent Name:
Date of Birth
Gender
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Male
Female
Are you a Student?
Please select
Yes
No
2nd Child/Dependent Name:
Date of Birth
Gender
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Male
Female
Are you a Student?
Please select
Yes
No
3rd Child/Dependent Name:
Date of Birth
Gender
Please select
Male
Female
Are you a Student?
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Yes
No
4th Child/Dependent Name:
Date of Birth
Gender
Please select
Male
Female
Are you a Student?
Please select
Yes
No
Please include any other Children and/or dependents along with their date of birth, gender, and whether they are currently a student.
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TERMS AND CONDITIONS
Renewal Conditions:
By joining a plan, you are authorizing
Simple Medical Benefits
to bill your credit card for the plan you have selected. This charge shall renew until you notify
Simple Medical Benefits
in writing of its cancellation. By joining you indicate you have read the terms and conditions of the plan.
This plan will automatically renew at the end of your membership term, and your credit card will be automatically charged the appropriate amount.
Termination Conditions:
Simple Medical Benefits
and Careington International Corporation (Careington) reserve the right to terminate plan members from its plan for any reason, including non-payment. If
Simple Medical Benefits
terminates the plan or your membership for a reason other than non-payment, you will receive a pro-rata refund of your membership fees.
Cancellation Conditions:
You have the right to cancel within the first 30 days after effective date or receipt of membership materials (whichever is later) and receive a full refund, less the processing fee, if applicable. If for any reason during this time period you are dissatisfied with the plan and wish to cancel and obtain a refund, you must submit a written cancellation request.
Simple Medical Benefits
will accept cancellation requests at any time and will stop collecting membership fees in a reasonable amount of time, but no later than 30 days after receiving a cancellation notice. Please send a cancellation letter and a request for refund with your name and member ID to
Simple Medical Benefits
,
5147 Sunlake Dr, Hoschton GA 30548
or fax to
678-221-0263
. You may also submit cancellation requests by email:
billing@simplemedicalbenefits.com
. When you cancel, you will continue to have access to the plan for the remainder of the period for which you have paid; your membership will terminate at the end of that period. The preceding sentence does not apply to quarterly, semi-annual or annual memberships in FL, ND and OK, where you will receive a pro-rata refund whenever you cancel.
Description of Services:
Please see the enclosed materials for a specific description of the programs included in your plan.
Limitations, Exclusions & Exceptions:
This plan is a discount membership program offered by Careington. Careington is not a licensed insurer, health maintenance organization or other underwriter of health care services. No portion of any provider’s fees will be reimbursed or otherwise paid by Careington. Careington is not licensed to provide and does not provide health care services or items to individuals. You will receive discounts for services at certain health care providers who have contracted with the plan. You are obligated to pay for all health care services at the time of service. Savings are based upon the provider’s normal fees. Actual savings will vary depending upon location and specific services or products purchased. Please verify such services with each individual provider. The plan’s discounts may not be used in conjunction with any other discount plan or program. All listed or quoted prices are current prices by participating providers and subject to change without notice. Any procedures performed by a non-participating provider are not discounted. From time to time, certain providers may offer products or services to the general public at prices lower than the discounted prices available through this plan. In such event, members will be charged the lowest price. Discounts on professional services are not available where prohibited by law. This plan does not discount all procedures. Providers are subject to change without notice and services may vary in some states. It is the member’s responsibility to verify that the provider participates in the plan. At any time Careington may substitute a provider network at its sole discretion. Careington cannot guarantee the continued participation of any provider. If the provider leaves the plan, you will need to select another provider. Providers contracted by Careington are solely responsible for the professional advice and treatment rendered to members and Careington disclaims any liability with respect to such matters.
Complaint Procedure:
If you would like to file a complaint regarding your plan membership, you must submit your complaint in writing to: Careington International Corporation, P.O. Box 2568, Frisco, TX 75034. You have the right to request an appeal if you are dissatisfied with the complaint resolution. After completing the complaint resolution process, if you remain dissatisfied you may contact your state insurance department.
I Agree with the Terms and Conditions (required)
*
I Agree
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Simple Medical Benefits Plan (Member + Dependents)
Telemedicine, Dental Discounts, Vision and LASIK Discounts, Rx Discounts, VPN service, Legal Assistance, Identity Theft Restoration
When would you like your membership plan to start?
*
(Enrollment process takes 3-5 business days)
Please select
First of this Month
First of next Month
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